NPI | 1285049767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2018039891) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2096) |
152W00000X Optometrist (Licence: WA OD 60471420) | |
Enumeration Date | 2014-06-24 |
Last Update Date | 2022-04-29 |