| NPI | 1104221043 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174M00000X Veterinarian (Licence: WA VT60241409)  | 
| Additional Taxonomies | 174M00000X Veterinarian (Licence: CA 19380)  | 
| Enumeration Date | 2014-11-04 | 
| Last Update Date | 2015-01-12 |