| NPI | 1558953935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-357-TA-D45) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3713) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2024-10-10 |