| NPI | 1508096512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL SC26TA845) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2009020664) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2016-11-21 |