NPI | 1912960923 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004317) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TX 06748TG) |
Enumeration Date | 2006-04-10 |
Last Update Date | 2021-04-01 |