| NPI | 1679877377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1866) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2010030908) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2013-01-24 |