| NPI | 1720494412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010939) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2016042251) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-07-11 |