| NPI | 1134143662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 12382) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA RN203081) |
| 363L00000X Nurse Practitioner (Licence: CA NPF4552) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-08 |