| NPI | 1689231649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3552-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005235) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-06-07 |