| NPI | 1245401108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001215) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA 1768) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2020-03-16 |