| NPI | 1124366190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002183) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OM00111400) |
| 152W00000X Optometrist (Licence: NJ 27OA00644800) | |
| 152W00000X Optometrist (Licence: MD TA2324) | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2020-05-21 |