| NPI | 1891841987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4784) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 01482) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2011-02-25 |