| NPI | 1164549515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2462) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002427) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-03-17 |