| NPI | 1508422056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56270) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010946) |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2021-08-18 |