| NPI | 1326320896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 865) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-C69-TA-906) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: AL S-C69-TA-906) | |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2012-09-07 |