| NPI | 1548314388 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000570) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1404-548T) | 
| 152W00000X Optometrist (Licence: PA OE007871T) | |
| Enumeration Date | 2007-01-22 | 
| Last Update Date | 2022-11-09 |