| NPI | 1285855791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2006014785) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-A91-TA-663) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2017-01-26 |