| NPI | 1033461165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VT 030.0133977) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 21297-875) |
| 152W00000X Optometrist (Licence: PA OEG002617) | |
| Enumeration Date | 2012-10-13 |
| Last Update Date | 2022-10-19 |