| NPI | 1144678772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60768074) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 4045ATI) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2021-09-10 |