| NPI | 1104087907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2091) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001695) |
| 152W00000X Optometrist (Licence: SC 1497) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-05-06 |