| NPI | 1659740538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 008625) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057772) |
| 363AM0700X Physician Assistant, Medical (Licence: TN PA0000002888) | |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2019-05-29 |