| NPI | 1386678324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001066) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA1688) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-01-25 |