| NPI | 1730268319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000000586) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 586) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2013-12-19 |