| NPI | 1497748255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2929ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00004057) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2017-11-17 |