| NPI | 1396967675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA1044) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MD Da 1044) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-04-23 |