| NPI | 1487170577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000004573) |
| 207Q00000X Family Medicine (Licence: NC 0010-07474) | |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2023-10-31 |