| NPI | 1477019875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56403) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 831469) |
| 363L00000X Nurse Practitioner (Licence: CA 95011129) | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2020-03-23 |