| NPI | 1841479391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009982) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1490) |
| 152W00000X Optometrist (Licence: NC 2408) | |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2015-05-14 |