| NPI | 1710014402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2328) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 3699) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |