| NPI | 1871823237 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 20882) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20648) | 
| 363L00000X Nurse Practitioner (Licence: CA NP20882) | |
| Enumeration Date | 2010-01-07 | 
| Last Update Date | 2015-06-18 |