| NPI | 1891809141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1750) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2006017812) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2012-08-21 |