| NPI | 1093062325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1914) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2013021002) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2016-03-15 |