| NPI | 1881074623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 078313) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1441) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2022-01-04 |