| NPI | 1114016938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 595) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2401) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2019-03-13 |