| NPI | 1083097547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI 838) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2063) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2017-03-27 |