| NPI | 1740387158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-534-TA-272) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S534-TA272) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-01-26 |