NPI | 1053895144 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1904-840AT) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OR ATI-4407) |
Enumeration Date | 2018-09-24 |
Last Update Date | 2019-11-06 |