NPI | 1003536749 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: LA 2012-958AT) |
Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-F05-TA-C64) |
152W00000X Optometrist (Licence: NY 009630) | |
Enumeration Date | 2022-09-01 |
Last Update Date | 2025-01-17 |