NPI | 1750674958 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4857) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002340) |
152W00000X Optometrist (Licence: NH 0854) | |
Enumeration Date | 2011-05-20 |
Last Update Date | 2013-05-14 |