| NPI | 1871572453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1644) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 1800) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2012-10-01 |