| NPI | 1962757302 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 17928) | 
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: SC 17928) | 
| Enumeration Date | 2012-07-23 | 
| Last Update Date | 2019-06-03 |