| NPI | 1417924648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046-009003) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO TO3352) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2017-04-21 |