| NPI | 1396748620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 3902TX) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2977AT) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2023-03-07 |