| NPI | 1255585378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2686) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WY 324T) |
| 152W00000X Optometrist (Licence: MT 803) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |