| NPI | 1659710192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2666) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV07966) |
| 152W00000X Optometrist (Licence: MI 4901004887) | |
| 152W00000X Optometrist (Licence: SC 2216) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2023-08-22 |