| NPI | 1326590761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53959) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005294) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2021-04-19 |