| NPI | 1124332333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2670) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010362) |
| 152W00000X Optometrist (Licence: TX 7859T) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2022-03-17 |