NPI | 1457027880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61380894) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003681) |
Enumeration Date | 2021-08-17 |
Last Update Date | 2023-06-22 |