| NPI | 1518512078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2696) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DC OP1000406) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2020-12-05 |