| NPI | 1982779898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1566) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 5394153-9934) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2008-10-02 |