| NPI | 1548265937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2003015588) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1666) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2007-07-08 |