| NPI | 1790747590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 0000002323) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 3945) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-07-08 |