NPI | 1295352987 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005481) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10379T) |
Enumeration Date | 2020-06-29 |
Last Update Date | 2021-12-09 |