NPI | 1780294231 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35061TLG) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WY 449T) |
152W00000X Optometrist (Licence: CO opt.0003614) | |
Enumeration Date | 2020-08-08 |
Last Update Date | 2023-01-12 |