| NPI | 1235478074 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19015)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 342093)  | 
| Enumeration Date | 2013-02-13 | 
| Last Update Date | 2013-02-13 |