| NPI | 1235241829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004247) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046-009638) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-05-23 |