| NPI | 1497748206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-000911) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 911) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2022-03-06 |