| NPI | 1689152530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 202003175) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011221) |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2020-02-17 |