| NPI | 1639452501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2236) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1654) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2014-10-15 |