| NPI | 1588723019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2404) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 2775) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-12-28 |