| NPI | 1306892294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1054) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02037) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2010-02-10 |