| NPI | 1386633626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI 667) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1309) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2021-12-20 |