| NPI | 1871155663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WY 436T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1521) |
| 152W00000X Optometrist (Licence: PA OEG003536) | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2023-03-23 |