| NPI | 1720410129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2414) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-D08-TA-952) |
| 152W00000X Optometrist (Licence: SC 1826) | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2021-01-13 |