| NPI | 1053894865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.011246) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IL 046.011246) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IL 046.011246) | |
| 156FC0800X Technician/Technologist, Contact Lens (Licence: IL 046.011246) | |
| Enumeration Date | 2018-09-09 |
| Last Update Date | 2019-04-06 |