| NPI | 1861621724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 9439507-9934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1861) |
| 152W00000X Optometrist (Licence: OK 2594) | |
| 152W00000X Optometrist (Licence: OH 5837) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2018-11-21 |