| NPI | 1942293204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO T02564) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 12452) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2011-11-28 |