| NPI | 1326442559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN OD3477) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1847) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2022-12-02 |