| NPI | 1356598080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA3124) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4769) |
| 152W00000X Optometrist (Licence: PA OEG002142) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2025-11-25 |