| NPI | 1447341300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004685) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1523) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2021-04-02 |