| NPI | 1376267864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG004124) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005649) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2024-05-29 |