| NPI | 1366179798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 49010056665) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18004356A) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2025-06-16 |