| NPI | 1366827800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002961) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2484) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-01-26 |