| NPI | 1831767821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM OPT-2024-0005) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 0003688) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2024-07-03 |