| NPI | 1659368983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001535) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 1616) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2024-05-28 |