| NPI | 1770058521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56099) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010232) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2020-10-09 |