| NPI | 1295894103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK A192) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OE008289T) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2017-03-03 |