| NPI | 1780799197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2840t) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3710) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-02-04 |