| NPI | 1033589601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: NM 75-18) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 75-18) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |