| NPI | 1982723474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA1480) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19157) |
| 363A00000X Physician Assistant (Licence: FL 9104999) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2023-12-15 |