| NPI | 1154495620 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 16389)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 531287)  | 
| 364S00000X Clinical Nurse Specialist (Licence: CA 2476)  | |
| Enumeration Date | 2006-11-17 | 
| Last Update Date | 2014-03-25 |