| NPI | 1538365044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00003222) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001881) |
| 152W00000X Optometrist (Licence: NJ TO00665) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2008-02-27 |