| NPI | 1629090097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2158) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2023007228) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-12-18 |