| NPI | 1275796955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002112) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002059) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-06-01 |