| NPI | 1639289663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-191-TA-865) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0601800197) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-09-28 |