| NPI | 1649526229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2887) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1726) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2014-08-12 |