| NPI | 1194202622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61087735) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 34002TLG) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2021-06-28 |