| NPI | 1104976596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046-009443) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2683) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2014-11-02 |