| NPI | 1215959663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0601800277) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001133) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-03-29 |