| NPI | 1497134399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-100359) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD60644428) |
| Enumeration Date | 2015-05-25 |
| Last Update Date | 2020-12-07 |