| NPI | 1114568383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 098023) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005399) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2023-07-18 |