| NPI | 1669661914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009809) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003372B) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-10-22 |