| NPI | 1356506521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1612) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2679) |
| 152W00000X Optometrist (Licence: OH 5299/T2837) | |
| 152W00000X Optometrist (Licence: FL OPC4834) | |
| Enumeration Date | 2008-07-27 |
| Last Update Date | 2023-08-23 |