| NPI | 1245393917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 094800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1495-674) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2020-10-11 |