| NPI | 1154618528 |
|---|---|
| Former Name | JENNIFER MARIA VIRAG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1717) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2011020051) |
| 152WP0200X Optometrist, Pediatrics (Licence: MO 2011020051) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: MO 2011020051) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2012-12-13 |