| NPI | 1063725208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1818DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN OD-T3032) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2012-08-15 |