| NPI | 1013072966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2008032353) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003068) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2011-08-17 |