| NPI | 1568725232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 117369) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1705) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2024-05-06 |