| NPI | 1285663336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2005020649) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2111) |
| 152W00000X Optometrist (Licence: IA 02337) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2024-05-02 |