| NPI | 1083607493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD 636) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 2392) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2023-06-29 |