| NPI | 1386618247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD DA2610) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004453) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2026-01-09 |