| NPI | 1982288163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2021025037) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: MO 2021025037) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-07-27 |