| NPI | 1740476118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PAC52759) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP6347) |
| 163W00000X Registered Nurse (Licence: CA RN417727) | |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2025-10-29 |