| NPI | 1366549289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA1807) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1367-501T) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-11-02 |