| NPI | 1740816768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61149900) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 4523) |
| 152W00000X Optometrist (Licence: CA 34549) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2022-10-13 |