| NPI | 1013355288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10724T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00695400) |
| 152W00000X Optometrist (Licence: PA OEG002799) | |
| 152W00000X Optometrist (Licence: WI 3959-35) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-11-07 |