| NPI | 1992050967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010565) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3881-35) |
| 152W00000X Optometrist (Licence: MI 4901005774) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-05-30 |