| NPI | 1891766515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 867) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: AZ 867) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2010-08-05 |