| NPI | 1285151910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002839) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2604) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2022-02-07 |