| NPI | 1265100242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 203599) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00709900) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-08-26 |