| NPI | 1477942357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05493) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2022-06-30 |