| NPI | 1376899237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2016002504) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1922) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2025-04-29 |