| NPI | 1578699005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000001981) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00034700) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2015-02-03 |