| NPI | 1629504535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000350) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2698) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-03-31 |