| NPI | 1356371108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP563) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA0924) |
| 152W00000X Optometrist (Licence: VA 0601001291) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-10-25 |