| NPI | 1952430480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2450) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: OK 2450) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |