| NPI | 1639790132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61060200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR ATI4597) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-06-07 |