| NPI | 1508446691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2169) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2022003682) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2022-10-11 |