| NPI | 1316252455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1805) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2680) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2015-04-28 |