| NPI | 1649408600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1849) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2887) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2010-05-19 |