NPI | 1114404456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5381) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005145) |
152W00000X Optometrist (Licence: KY 2206DT) | |
152WC0802X Optometrist, Corneal and Contact Management (Licence: KY 2206DT) | |
Enumeration Date | 2018-07-19 |
Last Update Date | 2024-08-13 |