| NPI | 1457462012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0001580) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 417) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-04-14 |