NPI | 1063662344 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: WY 406T) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2668) |
Enumeration Date | 2008-09-24 |
Last Update Date | 2021-07-27 |