| NPI | 1083669956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM 2457) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2152) |
| 152W00000X Optometrist (Licence: NC 2194) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-05-18 |