| NPI | 1679663850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000341) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: VA 0618000341) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2010-03-16 |