| NPI | 1912096942 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 15058)  | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 868844)  | 
| Enumeration Date | 2006-10-11 | 
| Last Update Date | 2022-02-11 |