| NPI | 1952955585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 002382) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002811) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-12-08 |