| NPI | 1578642500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 1914TX) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 1947T) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-10-31 |