| NPI | 1134262637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1560) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 2692759934) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2009-08-20 |