| NPI | 1215285978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2904) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2977) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |