| NPI | 1013062306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2821T) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: OR 2821T) |
| 152WP0200X Optometrist Pediatrics (Licence: OR 2821T) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-05-10 |