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 |