| NPI | 1558928648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2683) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 34221TLG) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2021-09-24 |