| NPI | 1700197027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 1076-OD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001940) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2010-07-01 |