| NPI | 1225021637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6404) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60776496) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2024-04-15 |