| NPI | 1265601413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA 0000002339) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2022-03-14 |