| NPI | 1063759678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1910DT) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: KY 1910DT) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2023-09-25 |