| NPI | 1104268267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3240) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005073) |
| 152W00000X Optometrist (Licence: CA 14717) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2022-04-04 |