| NPI | 1285113324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60905619) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 003109) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2024-05-23 |