| NPI | 1174524706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00003666) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0002891) |
| 152W00000X Optometrist (Licence: OR 2843AT) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2023-03-09 |