| NPI | 1912909292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA1122) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DE 1200) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2009-03-18 |