| NPI | 1740247915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1203-3) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO TO2537) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-03-13 |