| NPI | 1932231180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA 1352) |
| Additional Taxonomies | 208VP0000X (Licence: TN PA1352) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2015-09-01 |