| NPI | 1720302672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4909) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 654) |
| 152W00000X Optometrist (Licence: CA 13948) | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2019-01-31 |