| NPI | 1457978504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-E58) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003151) |
| Enumeration Date | 2020-07-05 |
| Last Update Date | 2023-07-13 |