| NPI | 1952549727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 002470) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1330) |
| Enumeration Date | 2009-02-01 |
| Last Update Date | 2015-09-02 |