| NPI | 1912969049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1793) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2303) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-08 |