NPI | 1699109025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1988) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 270A00646900) |
152W00000X Optometrist (Licence: NY 008073) | |
Enumeration Date | 2013-08-21 |
Last Update Date | 2015-03-17 |