| NPI | 1225115835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001009) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WV 925OD) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-12-08 |