| NPI | 1508877382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA18229) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA NP15895) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |