| NPI | 1568815496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002996) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 082907) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2023-08-31 |