| NPI | 1750729745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1946) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK PROCESSING) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-06-18 |