| NPI | 1053666818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.011481) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1888DT) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2021-09-24 |