| NPI | 1891822045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA14060) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PA14060) |
| 363L00000X Nurse Practitioner (Licence: CA NP014060) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-03-07 |