| NPI | 1518166933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR OR2520-ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2520-ATI) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2009-09-17 |