| NPI | 1558032102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MO 2022013961) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2259) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2025-08-13 |