| NPI | 1851393524 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 6271)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 480031)  | 
| Enumeration Date | 2005-08-12 | 
| Last Update Date | 2022-01-03 |