| NPI | 1568429447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA12011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 260226) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-11-05 |