| NPI | 1194140210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000218) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001999) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |