| NPI | 1700228756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA3057) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA OPT5015) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2025-02-26 |