| NPI | 1568957884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60963014) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002266) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2021-05-12 |