| NPI | 1952658023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2012027800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1917) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2013-12-12 |