| NPI | 1649553355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1936) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 638) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2017-05-15 |