| NPI | 1487062709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002630) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2007) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2021-05-07 |