| NPI | 1720081532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA1125) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-10-31 |