| NPI | 1497745384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 768-OD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WV MM0091544) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2013-12-05 |