| NPI | 1093979619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 817) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3265ATI) |
| Enumeration Date | 2008-07-13 |
| Last Update Date | 2021-10-15 |