| NPI | 1134807506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005759) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011769) |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2024-07-25 |