| NPI | 1356375992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000000054) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 1014617) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2025-09-11 |