| NPI | 1407544273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61434697) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA OD61434697) |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2024-11-13 |