| NPI | 1336692623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2764) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003222) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2018-03-20 |