| NPI | 1518271279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2227) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: MA 4811) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2013-06-18 |