| NPI | 1871653873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 639) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL 5903TA472) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-10-01 |