| NPI | 1609351022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 148261) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.011252) |
| 152W00000X Optometrist (Licence: FL OFC89) | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2021-01-04 |