| NPI | 1730365719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 4158) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00004158) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2022-07-18 |