| NPI | 1922107283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3627AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003132A) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-09-05 |