| NPI | 1194373514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57053) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA PA57053) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2021-07-28 |