| NPI | 1720227010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-100170) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID 100170) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2023-08-22 |