| NPI | 1972563633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1538) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001962) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2010-02-05 |