| NPI | 1528628062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD 761) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MN 3624) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2020-09-16 |