| NPI | 1053413047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3168ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00004093) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2009-10-05 |