| NPI | 1265673552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 1830) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL PA-626) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2012-01-10 |