| NPI | 1922396076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1812) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2011019156) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: MO 2011019156) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2020-07-15 |