| NPI | 1144410911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2171) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 00004135) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2013-03-29 |