| NPI | 1538682992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3374) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2943) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2023-05-05 |