NPI | 1548512874 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: HI OD-830) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33362) |
152W00000X Optometrist (Licence: WA OD60574434) | |
Enumeration Date | 2012-10-10 |
Last Update Date | 2020-08-21 |