| NPI | 1013908938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2005019125) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046009808) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2014-10-02 |