| NPI | 1316460827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1486) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2063) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2021-05-20 |