| NPI | 1205024395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2327) |
| Additional Taxonomies | 152WX0102X Optometrist, Occupational Vision (Licence: TX 7131T) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2022-09-14 |