| NPI | 1003536749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 2012-958AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009630) |
| 152W00000X Optometrist (Licence: AL S-F05-TA-C64) | |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2024-10-14 |