| NPI | 1033583190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54369) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 3698-23) |
| 363L00000X Nurse Practitioner (Licence: WI 3698-23) | |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2021-06-26 |