| NPI | 1093706673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PR 359) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PR 0130) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |