| NPI | 1669855110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA LA1854-788AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3255) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2021-04-02 |