| NPI | 1295264380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2504) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002580) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2021-12-13 |