| NPI | 1447457452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR ATI3218) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00004138) |
| 152W00000X Optometrist (Licence: OR 3218ATI) | |
| 152W00000X Optometrist (Licence: WA OD4138) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-11-19 |