| NPI | 1750467346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA11624) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA11624) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 282419) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2021-12-15 |