| NPI | 1942722962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3349) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 347735) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-12-19 |