| NPI | 1740856798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WONG Optometrist 301-385-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |