| NPI | 1982082731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004954) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010907) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2016-11-18 |