| NPI | 1104863356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00001906) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: WA OD00001906) |
| 152WV0400X Optometrist, Vision Therapy (Licence: WA OD00001906) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: WA OD00001906) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-05-08 |