| NPI | 1205406048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2245DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: HI OD-950) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-06-24 |