| NPI | 1558356980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003642) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 418) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2022-12-15 |