| NPI | 1235268061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1717) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3468) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2026-01-26 |