| NPI | 1760816177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002275) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8597TG) |
| 152W00000X Optometrist (Licence: PA OEG003494) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2021-12-14 |