| NPI | 1215368550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 772) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3531AT) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2021-01-26 |