| NPI | 1043696701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2471) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1896) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2017-04-27 |