| NPI | 1578584983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1260) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02353) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |