| NPI | 1932438587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1819) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 002789) |
| 152W00000X Optometrist (Licence: OR 3327ATI) | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2014-01-31 |