| NPI | 1093253247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002638) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003247) |
| 152W00000X Optometrist (Licence: MD TA2628) | |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2020-09-25 |