| NPI | 1235126129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1143) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003886) |
| 152W00000X Optometrist (Licence: PA OEG003988) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2023-05-04 |