| NPI | 1306077417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3330ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD60119602) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2014-01-31 |