| NPI | 1215138805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2007018501) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MO 2007018501) |
| 152WP0200X Optometrist, Pediatrics (Licence: MO 2007018501) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2015-11-04 |