| NPI | 1194175208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60721093) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010998) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2017-03-16 |