| NPI | 1609840495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD 562) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MT 644OPT) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2011-07-26 |