| NPI | 1154973220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2019019708) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.011340L) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2022-03-08 |