| NPI | 1376012534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2560) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003941) |
| 152W00000X Optometrist (Licence: SC 2101) | |
| Enumeration Date | 2018-11-17 |
| Last Update Date | 2023-10-19 |