| NPI | 1871806463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2010020643) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2361) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2022-12-28 |