| NPI | 1083274740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9688) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 4659ATI) |
| 152W00000X Optometrist (Licence: CO OPT.0003814) | |
| 152W00000X Optometrist (Licence: MN 3857) | |
| 152W00000X Optometrist (Licence: NV 1178) | |
| Enumeration Date | 2019-06-15 |
| Last Update Date | 2024-04-18 |