| NPI | 1861507386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 2262-035) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 03990) |
| 152W00000X Optometrist (Licence: MI 4901003299) | |
| 152W00000X Optometrist (Licence: OH 4051/T1031) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2025-09-11 |