| NPI | 1508160482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3391) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2115) |
| 363AM0700X Physician Assistant Medical (Licence: GA 005991) | |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2023-01-17 |