| NPI | 1134265218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00004010) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12906T) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2019-01-15 |