| NPI | 1194935668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 2456) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4607) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-06-25 |