| NPI | 1154977759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005504) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011348) |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2021-04-19 |