| NPI | 1982617411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ME 895) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2416) |
| 152W00000X Optometrist (Licence: AR 2557) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2011-03-21 |