| NPI | 1669524757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP 826) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA 1613) |
| 152W00000X Optometrist (Licence: VA 06018000927) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |