| NPI | 1164947248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2623) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002906) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2023-06-19 |