| NPI | 1457374563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 957) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 915) |
| 152W00000X Optometrist (Licence: SD 522) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-11-20 |