| NPI | 1962767525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010586) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003751A) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2018-04-26 |