| NPI | 1447788054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002575) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2845) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2022-05-11 |