| NPI | 1215932272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA PA15047) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA15047) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2021-01-15 |