| NPI | 1649688078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-100527) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2825) |
| 152W00000X Optometrist (Licence: WA 60892989) | |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2023-03-10 |