| NPI | 1073948311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003113) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3511AT) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2023-02-14 |