| NPI | 1215242300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1973) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: HI OD730) |
| 152W00000X Optometrist (Licence: OH 5999) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2014-09-28 |