| NPI | 1477696656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC nc1568) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN tn1430) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2013-06-27 |