| NPI | 1306031406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 19439) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 17692) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2023-05-18 |