| NPI | 1508109455 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA 60633823) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD60633823) | 
| Enumeration Date | 2013-03-28 | 
| Last Update Date | 2019-03-21 |