| NPI | 1861704538 |
|---|---|
| Former Name | TRAVONDA MEKIA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 2824) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02350) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2022-07-21 |