| NPI | 1720053952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 661) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2280) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2007-07-08 |