| NPI | 1669704565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 911) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD60128106) |
| 152W00000X Optometrist (Licence: OR 3486AT) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2019-08-05 |