| NPI | 1861620999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2009016952) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1853) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2011-03-02 |