| NPI | 1780939041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2400) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1721) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2020-12-21 |