| NPI | 1134319122 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 1084-OD)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2546)  | 
| Enumeration Date | 2007-07-26 | 
| Last Update Date | 2015-11-30 |