| NPI | 1184903536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2297) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MA 5047) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2016-02-11 |