| NPI | 1073036943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE I4-0000097) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AK 123305) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2019-04-16 |