| NPI | 1356915011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA0000004391) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007598) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-06-30 |