| NPI | 1053751701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 2015) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003802) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: AZ 2015) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2015-04-23 |