| NPI | 1659955920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: WA 61104188) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: OR ATI4547) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-05-12 |