| NPI | 1245218932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA13272) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 272543) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2013-09-23 |