| NPI | 1982964417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA52032) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA pa52032) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2019-09-03 |