| NPI | 1962691287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA3600) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: TN PA3600) |
| 363A00000X Physician Assistant (Licence: FL PA9104308) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2024-09-21 |