| NPI | 1164904611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2532) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2119DT) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2024-09-30 |