| NPI | 1407220585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004228) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2011DT) |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2020-09-16 |