| NPI | 1376900555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN TN3297) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2001DT) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2019-04-17 |