| NPI | 1538762992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2651) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2234) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2021-03-31 |