| NPI | 1821574419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 61188462) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008847) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2022-05-27 |