| NPI | 1164574646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA13619) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP7094c) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 7094) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2016-05-06 |