| NPI | 1023287067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60798589) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2639) |
| 152W00000X Optometrist (Licence: HI 764) | |
| 152W00000X Optometrist (Licence: MO 2005035713) | |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2020-11-13 |