| NPI | 1508914185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4619) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 8866) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2009-07-22 |