| NPI | 1427346212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2578) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2022) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2022-03-02 |