| NPI | 1699347013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5495) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2736) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-09-18 |