| NPI | 1255802021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002717) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2091) |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2021-10-26 |