| NPI | 1518090745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2837ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3693) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-08-10 |