| NPI | 1982898078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2007022317) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1816) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2014-12-16 |