| NPI | 1407847445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2472AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 99165899 OPT 1658) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2019-07-15 |