| NPI | 1255644993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1606-639T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 685) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2020-10-19 |