| NPI | 1831486901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.010549) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2011018493) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2024-08-30 |