| NPI | 1669927505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 960) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2033DT) |
| Enumeration Date | 2016-08-21 |
| Last Update Date | 2018-03-17 |