| NPI | 1942671342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2852) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2852) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2018-09-04 |