| NPI | 1205682192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MI 4901005794) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005794) |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2025-11-10 |