| NPI | 1265847990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60479528) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14992) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2021-04-28 |