| NPI | 1891777629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1188) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02310) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2012-07-02 |