| NPI | 1609425867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2592) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2592) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |