| NPI | 1316493158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60685047) |
| Additional Taxonomies | 152WX0102X Optometrist, Occupational Vision (Licence: WA 60685047) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2023-10-05 |