| NPI | 1558659375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-100233) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD60229944) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2021-04-08 |