| NPI | 1528555778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046011189) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003153) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2019-11-11 |