| NPI | 1326035544 |
|---|---|
| Former Name | RITA DEBBIE WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2976AT) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: OR 2976AT) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2013-07-17 |