| NPI | 1881614022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2005020671) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.009784) |
| 152W00000X Optometrist (Licence: IN 18003661A) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-05-13 |