| NPI | 1740348911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 1948) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1010) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2013-08-27 |