| NPI | 1801418157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005559) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV009200) |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2025-02-12 |