| NPI | 1902803323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1388) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: NC 1388) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2010-10-13 |