NPI | 1386618247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MD DA2610) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MI 49010004453) |
Enumeration Date | 2006-02-15 |
Last Update Date | 2019-03-22 |