| NPI | 1538190400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO T03392) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1494-3) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-05-09 |