| NPI | 1295014256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002735) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002530) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2022-01-24 |