| NPI | 1962069450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0000000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002554) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2021-12-06 |