| NPI | 1205183738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61185620) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3453ATI) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2022-08-06 |