| NPI | 1770902124 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN238548) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 850946) | 
| 164X00000X Licensed Vocational Nurse (Licence: CA 254771) | |
| Enumeration Date | 2014-04-14 | 
| Last Update Date | 2024-05-10 |