| NPI | 1144210519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO T03344) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046-009203) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-06-10 |