| NPI | 1972158962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 2216) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2589) |
| 152W00000X Optometrist (Licence: MO 2023018209) | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2024-09-18 |