| NPI | 1811980964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009248) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2163) |
| 152W00000X Optometrist (Licence: MO 2011037755) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2023-03-07 |