| NPI | 1861628224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PR 629) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6875) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2014-02-17 |