| NPI | 1063662344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WY 406T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2668) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2021-07-27 |