| NPI | 1013953827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP12158) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2008-06-20 |