| NPI | 1174878375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: KY 2120DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8442TG) |
| 152W00000X Optometrist (Licence: IL 046.010570) | |
| 152W00000X Optometrist (Licence: KY 2120DT) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2018-12-28 |