| NPI | 1194758581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 02040) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT1692) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2016-01-25 |