| NPI | 1871607069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001704) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3147T) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2017-02-07 |