| NPI | 1356605695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60291678) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3449ATI) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2016-06-21 |