| NPI | 1154585628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3274ATI) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: AZ 1870) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2017-03-03 |