| NPI | 1619460250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000424) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002653) |
| 152W00000X Optometrist (Licence: MD TA2702) | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2025-06-05 |