| NPI | 1366692626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD DA1710) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001122) |
| 152W00000X Optometrist (Licence: TX 03569T) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |