| NPI | 1235126376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA OPT12839) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02361) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2015-05-12 |