| NPI | 1285284679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002377) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 346.004082) |
| 152W00000X Optometrist (Licence: IL 046.011350) | |
| 152W00000X Optometrist (Licence: AZ P002155A) | |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-11-01 |