| NPI | 1760104749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-334-TA-D05) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN TN3756) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2024-01-03 |