| NPI | 1902930126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 1874) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: WA 1874) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-01-30 |