| NPI | 1215160361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8298) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010201) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2021-05-20 |