| NPI | 1407420136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61169377) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2871) |
| 152W00000X Optometrist (Licence: FL TPOP184) | |
| 152W00000X Optometrist (Licence: NH 1203) | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-09-13 |