| NPI | 1811259336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 1939) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 8339880-9934) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2019-09-03 |