| NPI | 1144725268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-312-TA-C54) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3080) |
| 152W00000X Optometrist (Licence: CA OPT34109-TLG) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2022-03-08 |