| NPI | 1134571649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2043) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2016020868) |
| 152W00000X Optometrist (Licence: WI 3459) | |
| 152WP0200X Optometrist, Pediatrics (Licence: KS 2043) | |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2023-01-13 |