| NPI | 1366705360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 1099-IOD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-C82) |
| 152W00000X Optometrist (Licence: VA 0618002232) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2014-06-13 |