| NPI | 1699240200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005164) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MI 4901005164) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-04-23 |