| NPI | 1124065479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2026) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2405) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2014-10-20 |