| NPI | 1184186538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: WA 61265942) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9541T) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: OR 4558) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2022-03-04 |