NPI | 1033461165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: VT 030.0133977) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WI 21297-875) |
152W00000X Optometrist (Licence: PA OEG002617) | |
Enumeration Date | 2012-10-13 |
Last Update Date | 2022-10-19 |