| NPI | 1205055662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1612) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12211T) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-08-25 |