| NPI | 1912425299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3420) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: TN 3420) |
| 152WP0200X Optometrist Pediatrics (Licence: TN 3420) | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |