| NPI | 1205211349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2013) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2015020237) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2025-11-12 |