| NPI | 1043337611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA pa12887) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 283846) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |