| NPI | 1487967105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.010630) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2654) |
| 152W00000X Optometrist (Licence: MO 2010022775) | |
| 152W00000X Optometrist (Licence: TX 7694T) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2015-01-23 |