| NPI | 1619590403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046011414) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD NA2906) |
| 152W00000X Optometrist (Licence: WI 3872-35) | |
| 152W00000X Optometrist (Licence: CO OPT.0003884) | |
| 152W00000X Optometrist (Licence: FL TPOP108) | |
| 152W00000X Optometrist (Licence: VT 030.0133976) | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-03-10 |