| NPI | 1477048452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2674) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003405) |
| 152W00000X Optometrist (Licence: VA 0618002789) | |
| 152W00000X Optometrist (Licence: TX 10384T) | |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2024-04-08 |