| NPI | 1770714537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001872) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2903) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2013-08-29 |