| NPI | 1831101393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2453) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 057) |
| 152W00000X Optometrist (Licence: MI 4901003335) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |