| NPI | 1710943972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL T174TA519) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2203) |
| 152W00000X Optometrist (Licence: SC 1055) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2012-12-03 |