| NPI | 1245334630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60176880) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12852 TPL) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2010-12-10 |