| NPI | 1720092588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 3891TX) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 00003891TX) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2013-01-09 |