| NPI | 1700147576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2941) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-C85) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-04-04 |