| NPI | 1912957614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 1190) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 1153) |
| 367A00000X Advanced Practice Midwife (Licence: TN PA001190) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2012-02-07 |