| NPI | 1316933989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1409) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1241) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2008-10-02 |