| NPI | 1154798999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010972) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3449) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2017-10-04 |