| NPI | 1598288565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005687) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003281) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2024-04-16 |