| NPI | 1962278747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3986-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2023047487) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2024-08-22 |