| NPI | 1558461012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC 7621000632) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD DA1177) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2021-06-02 |