| NPI | 1326077157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP564) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA0830) |
| 152W00000X Optometrist (Licence: VA 0601-001171) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2007-07-08 |