| NPI | 1639630593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61469527) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008926) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-09-30 |