| NPI | 1790289510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1101X Technician/Technologist Ophthalmic Assistant |
| Additional Taxonomies | 156FC0800X Technician/Technologist Contact Lens |
| 156FX1101X Technician/Technologist Ophthalmic Assistant | |
| 156FX1700X Technician/Technologist Ocularist | |
| 156FX1800X Technician/Technologist Optician | |
| 156FX1800X Technician/Technologist Optician | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2022-09-01 |