| NPI | 1255715082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002438) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2483) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2024-05-16 |