| NPI | 1710929526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 002530) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG 001307) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-09-21 |