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 |