| NPI | 1053542530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2820) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 619) |
| Enumeration Date | 2009-08-02 |
| Last Update Date | 2024-01-23 |