| NPI | 1013908656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1190) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1728) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2021-10-26 |