| NPI | 1326117920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA RN457272) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52203) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2015-07-31 |