| NPI | 1386044121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60484667) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: WA OD60484667) |
| 152WV0400X Optometrist, Vision Therapy (Licence: WA OD60484667) | |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |