| NPI | 1548210032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2003014792) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046-009535) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2019-04-12 |