| NPI | 1114998812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S595TA298) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-595-TA-298) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-05-12 |