NPI | 1356375992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: 1014617) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000000054) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-08 |