| NPI | 1477276905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002597) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2597) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2023-08-01 |