| NPI | 1316137250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ T3017804) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1124) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2023-06-09 |