| NPI | 1669762217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3549) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AK 109659) |
| 152W00000X Optometrist (Licence: NY 008051) | |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2023-08-02 |