| NPI | 1508802067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1391) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 5324) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-09-23 |