| NPI | 1861829053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA2583) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN PA0000002583) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2015-10-22 |