NPI | 1184849002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 13239 TPA) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006896-1) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2008-07-15 |