| NPI | 1639258411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 764) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1428-569T) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-10-23 |