| NPI | 1629382189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 072224) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2296) |
| 152W00000X Optometrist (Licence: PA OEG002348) | |
| 152W00000X Optometrist (Licence: VA 0618002067) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2018-12-07 |