| NPI | 1972252898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 210038) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003128) |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2023-08-11 |