| NPI | 1588648034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3178) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 3362) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2016-04-13 |