| NPI | 1275575722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 589) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12895) |
| 152W00000X Optometrist (Licence: HI 634) | |
| 152W00000X Optometrist (Licence: UT 5949006-9934) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2015-06-23 |