| NPI | 1730174210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO T03197) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1419-3) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2007-07-08 |