| NPI | 1114579992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3980) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2693) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2025-04-09 |