| NPI | 1639365984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 00003925) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00003925) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2021-12-17 |