| NPI | 1861629826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 083581) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1585) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2020-08-27 |