| NPI | 1992452627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3435) |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2025-12-03 |