| NPI | 1720651912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.011542) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 3845) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2023-04-28 |