| NPI | 1366979528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2069DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3371) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2018-09-25 |