| NPI | 1407020167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60013347) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3230ATI) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-05-16 |