| NPI | 1053354399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000225) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002022) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2021-05-28 |