| NPI | 1073563433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1341-47ST) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1249) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-08-03 |