| NPI | 1275544397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA0818) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00099) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2011-09-08 |