| NPI | 1518310283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60668389) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP-100401) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2020-12-07 |