| NPI | 1609271790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2494) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5048) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2023-09-11 |