| NPI | 1376685966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002984) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT 12954TPA) |
| 152W00000X Optometrist (Licence: WI 3640-35) | |
| 152W00000X Optometrist (Licence: FL TPOP23) | |
| 152W00000X Optometrist (Licence: NY 009190) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-01-19 |