| NPI | 1073966479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60944749) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT33373) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-11-09 |