| NPI | 1770932519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2114) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3413-35) |
| Enumeration Date | 2016-06-11 |
| Last Update Date | 2022-04-08 |