| NPI | 1790823201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: TN TN 1239) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: TN TN 1239) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |