NPI | 1356608053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1655) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2233) |
Enumeration Date | 2012-04-19 |
Last Update Date | 2020-09-30 |