| NPI | 1801247267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1509) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003300) |
| 152W00000X Optometrist (Licence: PA OEG003151) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2021-04-20 |