| NPI | 1306056098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 15998) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 12827) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |