| NPI | 1649758640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005130) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2814) |
| 152W00000X Optometrist (Licence: NE 1559) | |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2024-08-02 |