| NPI | 1366615791 | 
|---|---|
| Other Name | SANDRA IMADE ODIASE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 17711) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 17711) | 
| Enumeration Date | 2008-04-07 | 
| Last Update Date | 2015-08-10 |