| NPI | 1407592272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINUTHA ASHWIN Credentialing Specialist 615-488-0706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-05-05 |