| NPI | 1619942059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA0000002180) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000756A) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2013-05-14 |