| NPI | 1275580896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 942) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WY 256T) |
| 152W00000X Optometrist (Licence: CO 2069) | |
| 152W00000X Optometrist (Licence: OR 3585AT) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2023-12-28 |