| NPI | 1073777033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2007035140) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010176) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-10-23 |