| NPI | 1013997147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD 578) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02198) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2015-02-27 |