| NPI | 1588939672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA11454) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 308876) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2013-03-27 |