| NPI | 1518902089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3556AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6553T) |
| 152W00000X Optometrist (Licence: IL 046-009692) | |
| 152W00000X Optometrist (Licence: WA OD 60529922) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2022-02-04 |