| NPI | 1982034401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1950) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002624) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2021-03-25 |