| NPI | 1396901674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2616) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2008022656) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2014-09-15 |