NPI | 1972503076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: DE C130001159) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OE005871T) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2019-10-18 |