| NPI | 1770965659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1455) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 078273) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2022-12-21 |