| NPI | 1649363946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2008) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MD TA2008) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-01-28 |