| NPI | 1366836009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002309) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2450) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2022-02-25 |