| NPI | 1083363360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003876) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002612) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2024-10-14 |