| NPI | 1366963092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000383) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002650) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2018-10-29 |