| NPI | 1194935957 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 15649) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 613088) | 
| 364S00000X Clinical Nurse Specialist (Licence: CA 2250) | |
| Enumeration Date | 2007-05-23 | 
| Last Update Date | 2025-09-11 |