NPI | 1326077157 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP564) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA0830) |
152W00000X Optometrist (Licence: VA 0601-001171) | |
Enumeration Date | 2006-07-02 |
Last Update Date | 2007-07-08 |