| NPI | 1710115902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000335) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010242) |
| 152W00000X Optometrist (Licence: NE 1344) | |
| 152W00000X Optometrist (Licence: VA 0618002473) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2016-03-20 |