| NPI | 1669430211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE 13-0001241) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA1463) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-09-22 |