| NPI | 1629273461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19779) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 765649) | 
| Enumeration Date | 2007-06-20 | 
| Last Update Date | 2013-07-01 |