| NPI | 1215377809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 889) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3101) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2014-09-04 |