| NPI | 1528636735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2807) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003031) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2024-05-13 |