| NPI | 1730523788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60503088) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3579ATI) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-10-03 |