| NPI | 1063761807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 78940) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 2082) |
| 163W00000X Registered Nurse (Licence: CA 704622) | |
| 163W00000X Registered Nurse (Licence: ID 78940) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2026-05-26 |