| NPI | 1588750194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTA00547) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 05575T) |
| 152W00000X Optometrist (Licence: HI OD681) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-02-26 |