| NPI | 1710331160 |
|---|---|
| Former Name | REBECCA CLAIRE LANGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10079T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60764823) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2021-01-28 |