| NPI | 1316929854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI 392T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2504T) |
| 152W00000X Optometrist (Licence: CA 11830TPA) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |