| NPI | 1720219009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1751) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2009021551) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2010-08-04 |