| NPI | 1174786925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002123) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2788) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-05-16 |