| NPI | 1275985616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2124) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 3235) |
| 152W00000X Optometrist (Licence: AZ 2139) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2020-11-06 |