| NPI | 1144607037 |
|---|---|
| Former Name | LISA WONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: WA 60571947) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: CA 33465) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2016-12-01 |