| NPI | 1972696722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 199077) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3574-tx) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-10-23 |