| NPI | 1487630067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000013) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618000958) |
| 152W00000X Optometrist (Licence: MD DA2396) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2021-12-20 |