| NPI | 1104849769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2431) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2124) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-07-24 |