| NPI | 1255397501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105288) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000001010) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-06-27 |