| NPI | 1285776575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 4120) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3186T) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2013-05-07 |