| NPI | 1306834965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-001255) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1216) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-10-27 |