| NPI | 1295772853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2819ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 333) |
| 152W00000X Optometrist (Licence: HI 458) | |
| 152W00000X Optometrist (Licence: TX 5365T) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-07-08 |