| NPI | 1689662801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 20116) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 1386) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-02-04 |