| NPI | 1588615132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 236) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SD 660) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-07-31 |