| NPI | 1356608053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1655) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2233) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2020-09-30 |