| NPI | 1255371407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2282) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901003970) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-12-26 |