| NPI | 1275983827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3225) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1937) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2019-12-04 |