| NPI | 1760601587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53253) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD 35) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-02-04 |