| NPI | 1851741425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2017DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18004061A) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2019-06-11 |