| NPI | 1699742684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002640) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VT 0300000348) |
| 152W00000X Optometrist (Licence: MA 4543) | |
| 152W00000X Optometrist (Licence: UT 8163077-9934) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2018-03-22 |