NPI | 1366884520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA14895) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 6420) |
Enumeration Date | 2013-07-29 |
Last Update Date | 2024-10-23 |