| NPI | 1538189659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003566A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1516) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2013-03-05 |