| NPI | 1073734224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MI 4901003317) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3960-35) |
| 152W00000X Optometrist (Licence: ID ODP-100639) | |
| 152W00000X Optometrist (Licence: PA OEG004118) | |
| 152W00000X Optometrist (Licence: NH 1096) | |
| 152W00000X Optometrist (Licence: FL TPOP199) | |
| 152W00000X Optometrist (Licence: IA 125753) | |
| 152W00000X Optometrist (Licence: MO 2024027128) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2024-09-04 |