| NPI | 1750836649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-0002571) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3001) |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2022-04-27 |