| NPI | 1104054964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2187) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003608) |
| 152W00000X Optometrist (Licence: VA 0618001935) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2014-12-18 |