| NPI | 1083658207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE 13-0001212) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DE 130001212) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2015-06-08 |