| NPI | 1033464458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1906DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003756A) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2015-04-20 |