| NPI | 1083979173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002131) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2306) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2018-01-31 |