| NPI | 1205400819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2249DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18004263A) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2022-10-20 |