| NPI | 1487067534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY 1903) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2016-03-10 |