| NPI | 1700454667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-E93-TA-C44) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2282) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2022-04-04 |