| NPI | 1972875706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 21023) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 733976) |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: CA 733976) | |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2021-03-09 |