| NPI | 1164763058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14592) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2305) |
| 152W00000X Optometrist (Licence: AK 134200) | |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2022-05-17 |