| NPI | 1659608263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 002477) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2767) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2022-12-05 |