| NPI | 1912294489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61024190) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003298) |
| 152W00000X Optometrist (Licence: AL SD14TA953) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2021-02-10 |