| NPI | 1811036056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2960) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3269) |
| 152W00000X Optometrist (Licence: FL TPOP48) | |
| 152W00000X Optometrist (Licence: MD TA2880) | |
| 152W00000X Optometrist (Licence: WI 3498-35) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2023-03-06 |