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 |