| NPI | 1073891016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21713) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 21665) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2019-05-31 |