| NPI | 1114449659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 002250) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VT 030.0133938) |
| 152W00000X Optometrist (Licence: TX 10144) | |
| 152W00000X Optometrist (Licence: OH 007211) | |
| 152W00000X Optometrist (Licence: CO 0003364) | |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2025-04-04 |