| NPI | 1952301673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1326) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3827) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2011-08-05 |