| NPI | 1962589739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 2658) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004381) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |