| NPI | 1518489723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2506) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2000) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2018-10-17 |