| NPI | 1275753899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP17182) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19132) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-11-04 |