| NPI | 1336590116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60663734) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: WA 60663734) |
| 152W00000X Optometrist (Licence: MN 3592) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: WA 60663734) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2018-09-12 |