| NPI | 1750525820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60096396) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: HI 707) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-09-16 |