| NPI | 1295044378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60385641) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP-100287) |
| 152W00000X Optometrist (Licence: OR 3498ATI) | |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2017-04-26 |