| NPI | 1518495191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 122140) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 0003234) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2020-11-13 |