| NPI | 1689891459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PR 751) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VI 45) |
| 152W00000X Optometrist (Licence: MI 4901004883) | |
| 152W00000X Optometrist (Licence: GA opt003215) | |
| 152W00000X Optometrist (Licence: OH opt007016) | |
| 152W00000X Optometrist (Licence: MD da2480) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-11-14 |