| NPI | 1487617767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60498245) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2930AT) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2016-04-05 |