| NPI | 1629381769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2010020647) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010369) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2018-11-06 |