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 | 2018-06-19 |