| NPI | 1366497661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004081) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL TPOP149) |
| 152W00000X Optometrist (Licence: AZ OPT-002655) | |
| 152W00000X Optometrist (Licence: MI rq004081) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2023-04-19 |