| NPI | 1538295670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 3802) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: WA 3802) |
| 152WV0400X Optometrist, Vision Therapy (Licence: WA 3802) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2012-10-09 |