| NPI | 1043985914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003866) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002524) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2023-01-25 |