| NPI | 1619228731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60412689) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5197) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2022-10-19 |