NPI | 1851622237 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2457) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
363AM0700X Physician Assistant, Medical (Licence: GA 006735) | |
363AM0700X Physician Assistant, Medical (Licence: TN 2457) | |
Enumeration Date | 2010-01-25 |
Last Update Date | 2025-05-08 |