| NPI | 1922420546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA3035) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 7081) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2016-09-16 |