| 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 |