| NPI | 1699080648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 826) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2667) |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2011-08-12 |