| NPI | 1619263613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 701) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14186) |
| 152W00000X Optometrist (Licence: WA OD60229364) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-02-15 |