| NPI | 1285914820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2360) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1672) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2018-03-17 |