| NPI | 1518027028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000056) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA1072) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-06-02 |