| NPI | 1770626947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 1681) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1656) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |