| NPI | 1639788961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005858) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3639) |
| 152W00000X Optometrist (Licence: NC 2668) | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2025-10-13 |