| NPI | 1164546362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-B31-TA-725) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1684DT) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-11 |