| NPI | 1003881863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1464) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO T03242) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2010-10-19 |