| 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 |