| NPI | 1811517899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5469) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3187) |
| 152W00000X Optometrist (Licence: TX 10023) | |
| 152W00000X Optometrist (Licence: WI 3878-35) | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-03-06 |