| NPI | 1265597132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1590-3) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO TO3440) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-07-08 |