| NPI | 1942253240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2411) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WY 285T) |
| 152W00000X Optometrist (Licence: FL opc 4020) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-09 |