| NPI | 1295716629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 16840) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA RN 547915 NP 14011) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2007-08-30 |