| NPI | 1194601815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA66901) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA PA66901) |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-15 |