| NPI | 1821728130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.011942) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10610TG) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2025-02-27 |