| NPI | 1619283314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010376) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2010020580) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2012-09-24 |