NPI | 1679826135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1520) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2015012018) |
152W00000X Optometrist (Licence: TX 5564) | |
Enumeration Date | 2012-10-22 |
Last Update Date | 2020-09-18 |