| NPI | 1184157596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005125) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011091) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2020-02-10 |