| NPI | 1922238765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2010004182) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010226) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2013-01-08 |