| NPI | 1821307844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3359ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD 60160108) |
| Enumeration Date | 2010-09-26 |
| Last Update Date | 2012-07-20 |