| NPI | 1003918921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-A82-TA-661) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003515) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2019-08-19 |