| NPI | 1992347181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3148) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2023004714) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2023-04-12 |