| NPI | 1366948234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2022045656) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DC OP1000415) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2024-12-30 |