| NPI | 1710336201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5206) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA 2527) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-08-25 |