| NPI | 1437775004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2740) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003004) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2022-04-21 |