| NPI | 1073136479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2020013169) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2152) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2023-03-30 |