| NPI | 1528794716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: AZ OTP-002611) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OTP-002611) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2023-07-18 |