| NPI | 1336493840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010921) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4950) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2016-11-17 |