| NPI | 1508053224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5312) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1537) |
| 152W00000X Optometrist (Licence: IL 046009734) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2019-02-24 |