| NPI | 1962919605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: CT 001623) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: CT 001623) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-06-16 |