| NPI | 1811276850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2302) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4880) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2022-04-28 |