| NPI | 1275940603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3356) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010830) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2022-04-05 |