| NPI | 1992087811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60248713) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010507) |
| 152W00000X Optometrist (Licence: CO OPT-2873) | |
| 152W00000X Optometrist (Licence: OR 3485AT) | |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2017-05-09 |