| NPI | 1548576671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60167666) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3364AT) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-10-28 |