| NPI | 1417692161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 114824) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10432) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-10-28 |