NPI | 1366458580 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: AL R157TA743) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00458000) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2011-03-24 |