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 |