| NPI | 1760034821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60971780) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60971780) |
| 152W00000X Optometrist (Licence: OR OD60971780) | |
| 152W00000X Optometrist (Licence: ID ODP-100502) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2020-11-13 |