| NPI | 1487062519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002715) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2013) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2022-12-07 |