| NPI | 1972730091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2009032890) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2001015114) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2021-09-21 |