| NPI | 1073946398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003056) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2363) |
| Enumeration Date | 2013-08-11 |
| Last Update Date | 2014-10-08 |