| NPI | 1629232921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60066487) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT 13694 TLG) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2017-07-07 |