| NPI | 1003041211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1828DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1524) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2019-12-17 |