| NPI | 1770912206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21937) | 
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: CA 3067) | 
| Enumeration Date | 2013-11-05 | 
| Last Update Date | 2015-01-11 |