| NPI | 1033216718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2130) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 453/ T2453) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2007-07-08 |