| NPI | 1346821725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3832-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009314) |
| Enumeration Date | 2021-04-18 |
| Last Update Date | 2023-03-03 |