| NPI | 1043693443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2424) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DC OP1000324) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-09-06 |