| NPI | 1689200156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3664) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 4520ATI) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2021-08-03 |