| NPI | 1275815706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60221877) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14247) |
| 152W00000X Optometrist (Licence: OR 3424AT) | |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2011-09-10 |