| NPI | 1023070562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 2000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 8926) |
| 152W00000X Optometrist (Licence: OR 1972) | |
| 152W00000X Optometrist (Licence: WA 2002) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2007-07-08 |